Investigating cognition to fully assess MS progression

Many people with MS experience cognitive problems, like memory disturbances or slowing down of information processing speed.

Cognitive functions are harder to measure than clinical disability and MRIs, so they are not routinely evaluated in clinical practice.

The concept of ‘no evidence of disease activity’ (NEDA) has recently emerged as an important outcome measure for MS in research studies or clinical trials. It means no relapses or disability progression and no new white matter lesions are identified with MRI. However, it is not known if maintaining NEDA has a positive impact on cognition or brain atrophy (shrinkage).

A research team from Italy carried out a study to evaluate the correlation between NEDA status, cognitive functions and brain shrinking.

They followed 42 people with relapsing remitting MS for two years and found that only 30.8% of them achieved NEDA status. About half of those with NEDA status still had deterioration of some cognitive functions.

The recommendation from this study is to include cognitive evaluation in the NEDA measure to comprehensively assess disease progression.